A day in the life of eating disorder treatment.

Mental Health

Jul 13

Written By

Age: 19, Year: 2014

Todays blog will be a bit different - more of a fact file of what is involved in intensive and holistic treatment for an eating disorder. I spent 8 months at the Butterfly Day Program run by Monash Health, one of the only programs like it in the country and from what I have seen, this type of program produces the best long term results for recovery.

The program ran from 9-3:30 Monday to Friday, with some people attending full time, and some only 3-4 days a week as they transitioned out of treatment. There was a maximum of 12 people in the program at any one time, with some staying 3 months and others up to a year, so the wait list was long. This has since changed due to increased need, so there is now a 3 month time limit for most people. This worries me a lot as after 3 months I was nowhere near ready to continue recovery on my own.

Days began at home, trying to eat the breakfast that was on my meal plan supported by mum. Then mum would drop me at the program as I was not allowed to drive. The overall program schedule when I was there was:

So every day began with a group meeting where we checked in and also started the day with a relaxation, mindfulness or Tai Chi exercise. It would then essentially just be different groups to break up the time between meals.

GROUPS

Mondays was all about setting us up for the week. Problem solving involved filling in sheets to address any problems we had encountered the previous week in order of seriousness, and ways to overcome them.

Then goal setting was a similar sheet but all around setting a small and achievable goal for the week to address the problem. We would have one goal for home and one for at program, and in the process of setting the goal also had to come up with a plan to achieve it and overcome obstacles.

In coping skills we were sometimes taught practical things such as breathing, mindful eating, scribble pages etc, and other times were taught theory such as what thoughts are and how to separate ourselves from them.

On tuesdays, Nutrition Education was exactly what it sounds like, being taught by our dietician, and then the dietician would come with us on a food challenge. This may involve going to the movies and having a muffin in the movie then lunch at Subway, or going to a cafe for lunch, or at times even ordering McDonalds to the house. The afternoon was left to free activity because this was typically the most stressful day of the week for many. This was important though as it was the biggest factor in normalising eating behaviour and choices in social situations.

Wednesdays was more of a fun day, as we had an awesome teacher come in and would do Tai Chi in the park followed by Education which was essentially just a school class with writing tasks and projects completely unrelated to eating disorders. Lifestyle was also a fun group with different activities each week, sometimes involving getting family to come in for a picnic in the park.

Thursdays was a shorter day, and the first group was body image where did a lot of great work around how we view ourselves, why we view ourselves that way, and changing our fixed mindsets. Two of the most impactful tasks we did there was to write three letters, one from ourselves to our body, one from our body to us, and one from our body to our eating disorder. The other was writing a very in depth manual of how to care for our body as if we were about to give it to someone else to look after.

Group Processes involved working together as a group to ensure the environment and relationships between each of us were conducive to recovery and address any problems that came up due to behaviours or grievances among participants. Then inspiring tools for change was an enlightening group looking into inspiring people that have overcome things or created change to elicit feelings of hope among the group.

Fridays was a full day again, where we looked at family relationships and how they had played a role in our illness, plus how we could use the strengths of our family unit to help us recover. Self identity was another cornerstone group where we compared our own healthy mind values to that of our eating disorder, and did exercises such as writing out our story and writing a letter to failure. Ending the day with art therapy was a great way to end the week and one of my favourite outlets for all the pent up emotion.

That covers the groups that got us between meals, but by far the toughest work was done in and around meal times, with preparing and eating our prescribed meal plan, then addressing the thoughts and emotions surrounding that in either Food and Feelings or Journalling.

MEAL TIMES

Meal times where highly monitored and ran to a strict schedule. When the time came, we would all be allowed to enter the kitchen and prepare our meal. There would be two therapists around at all times watching what we were doing, and we had to check off our items individually with one of them. Everything was measured, from the amount of nuts, to the amount of grams or mls an item had to be, to using teaspoon measures to measure the butter for our bread. Once we had prepared our chosen food we set it on the bench and had to sit in the lounge until everyone was ready. If we needed to go to the bathroom it had to be done before meals but this too was always supervised, with a therapist standing outside the door while we had to count out loud on the toilet (to make sure no one was purging).

Once everyone was ready we all carried our prescribed food to the table, and a therapist sat at each end. If you were in need of more supervision you were asked to sit next to one of them. There were many many rules around how we could eat. Rules such as not being allowed to take a drink between every bite. Not being allowed to chew too long before we swallowed. Having to take bites of food rather than break it into pieces in our hands. Full teaspoons of yoghurt. Hands above the table at all times. I could go on. Still we would try to get away with all our little rituals and find any way to still have some control. As we ate we played word games around the table, and had to participate unless we were really struggling/crying, which happened fairly often. We had precisely 15 minutes to eat snacks and 30 minutes to eat lunch, after which any food left on our plate was carried over to the next meal. If we didn't finish two meals in a row, we were sent home for the day. If we got caught somehow getting rid of food (an eating disordered mind is very creative), we were given a supplement to replace it. Once finished we had to show empty plates, cups and wrappers to a therapist. Immediately following meals we were still heavily supervised and most days went straight into food and feelings.

Food and Feelings was an outlet for separating ourselves from our eating disorders and learning to fight back. We filled in a page that was half dedicated to our ED thoughts, and the other half was space for us to come up with rebuttals to these thoughts. We would also own up to any behaviours we had used. After writing, everyone would read theirs aloud to the group, so that the group could then also rebut the ED thoughts and proved fuel against them. An example of a couple of days of this is:

Journalling also ended each week and was a more private space where we didn't share our writings. Reading back my journals now even I am alarmed at how different and distorted my mindset was. This one in particular highlights a lot of the re-occurring thoughts that I remember from the time - if you know anyone that struggles with an ED I hope this gives you more of an insight into the inner world and that it is about so much more than weight/numbers/looks.

That sums up days in the program about as well as a single blog post ever could. It would take a lot longer to do justice to just how intense and hard recovery is. Roller coaster doesn't even begin to describe it. After days at the program I would go home with mum usually to just watch movies and create my quote book to pass the time as I wasn't allowed to do much else and with my mind so chaotic from being at the program all day, I didn't have much capacity to. It was a long 8 months, but over my time there I made some amazing friends and saw beautiful guys and girls slowly come out of their shells and get well along the journey to recovery. Seeing others further along the path than me proved it was possible.

To show just how much can be achieved when the proper help is provided, I'll leave you with a poem I wrote just before I left. I'm hoping this provides a level of hope to those in or witnessing a similar journey. Recovery is hard, but it's possible.

As I look at my reflection, I finally start to see,
Something new, something different. Maybe this is me?
No longer the product of flaws and imperfections,
I find I'm simply looking at a foggy reflection.

How is it that this image has such power over my mind?
To the point where it itself can actually make me blind.
Blind to the story the mirror fails to tell,
Only seeing the negatives my mind knows all too well.

For the useless glass in front of me cannot portray my worth,
My talents or my fears or the story of my birth.
Really it tells you nothing, so why then do I care?
Why do I constantly just stand in front and stare?

Picking at each part, never viewing me as a whole.
This vessel of my being, protector of my soul.
Who even has the right, to say what is good and what is bad?
And why should I give others standards the power to make me sad?

The mirror used to haunt me, literally bring me to my knees.
Crying, wishing, screaming, can someone fix me, please?
I wanted to change my body, but I have come to find,
That my body isn't the problem and I need to change my mind.

For the people too shallow to look beyond what they can see,
Are not the sort of people that I want close to me.
Who cares what others think, of this structure that is mine.
Love it or hate it, either way is fine.

I will not apologise for the image you decide to see.
That's your choice and I am choosing to just happily be me.